This blog is about my 8 year old son Joey and our journey into diagnosing his PDD-NOS and Epilepsy, learning from it and helping others, as well as being a great place to store all the information I gather along the way.

ADHD

Attention deficit hyperactivity disorder (ADHD)

ADD; ADHD; Childhood hyperkinesis

Last reviewed: March 25, 2012.

ADHD
is a problem with inattentiveness, over-activity, impulsivity, or a
combination. For these problems to be diagnosed as ADHD, they must be
out of the normal range for a child's age and development.

Causes, incidence, and risk factors

ADHD
is the most commonly diagnosed behavioral disorder of childhood. It
affects about 3 - 5% of school aged children. ADHD is diagnosed much
more often in boys than in girls.
ADHD may run in families, but it
is not clear exactly what causes it. Whatever the cause may be, it
seems to be set in motion early in life as the brain is developing.
Imaging studies suggest that the brains of children with ADHD are
different from those of other children.
Depression, lack of sleep,
learning disabilities, tic disorders, and behavior problems may be
confused with, or appear with, ADHD. Every child suspected of having
ADHD should be carefully examined by a doctor to rule out possible other
conditions or reasons for the behavior.
Most children with ADHD
also have at least one other developmental or behavioral problem. They
may also have a psychiatric problem, such as depression or bipolar disorder.

Symptoms

The symptoms of ADHD fall into three groups:

Lack of attention (inattentiveness)

Hyperactivity

Impulsive behavior (impulsivity)

Some
children with ADHD primarily have the inattentive type. Others may have
a combination of types. Those with the inattentive type are less
disruptive and are more likely to not be diagnosed with ADHD.
Inattentive symptoms

Fails to give close attention to details or makes careless mistakes in schoolwork

Has difficulty keeping attention during tasks or play

Does not seem to listen when spoken to directly

Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace

Often loses toys, assignments, pencils, books, or tools needed for tasks or activities

Is easily distracted

Is often forgetful in daily activities

Hyperactivity symptoms:

Fidgets with hands or feet or squirms in seat

Leaves seat when remaining seated is expected

Runs about or climbs in inappropriate situations

Has difficulty playing quietly

Is often "on the go," acts as if "driven by a motor," talks excessively

Impulsivity symptoms:

Blurts out answers before questions have been completed

Has difficulty awaiting turn

Interrupts or intrudes on others (butts into conversations or games)

Signs and tests

Too
often, difficult children are incorrectly labeled with ADHD. On the
other hand, many children who do have ADHD remain undiagnosed. In either
case, related learning disabilities or mood problems are often missed.
The American Academy of Pediatrics (AAP) has issued guidelines to bring
more clarity to this issue.
The diagnosis is based on very specific symptoms, which must be present in more than one setting.

Children
should have at least 6 attention symptoms or 6
hyperactivity/impulsivity symptoms, with some symptoms present before
age 7.

The symptoms must be present for at least 6 months, seen in two or more settings, and not caused by another problem.

The
symptoms must be severe enough to cause significant difficulties in
many settings, including home, school, and in relationships with peers.

In
older children, ADHD is in partial remission when they still have
symptoms but no longer meet the full definition of the disorder.
The child should have an evaluation by a doctor if ADHD is suspected. Evaluation may include:

Parent and teacher questionnaires (for example, Connors, Burks)

Psychological evaluation of the child AND family, including IQ testing and psychological testing

Treatment

Treating
ADHD is a partnership between the health care provider, parents or
caregivers, and the child. For therapy to succeed, it is important to:

Set specific, appropriate target goals to guide therapy.

Start medication and behavior therapy.

Follow-up
regularly with the doctor to check on goals, results, and any side
effects of medications. During these check-ups, information should be
gathered from parents, teachers, and the child.

If treatment does not appear to work, the health care provider should:

Make sure the child indeed has ADHD

Check for other, possible medical conditions that can cause similar symptoms

Make sure the treatment plan is being followed

MEDICATIONS
A
combination of medication and behavioral treatment works best. There
are several different types of ADHD medications that may be used alone
or in combination.
Psychostimulants (also known as stimulants) are
the most commonly used ADHD drugs. Although these drugs are called
stimulants, they actually have a calming effect on people with ADHD.
These drugs include:

A nonstimulant drug called atomoxetine (Strattera) may work as well as stimulants, and may be less likely to be misused.
Some
ADHD medicines have been linked to rare sudden death in children with
heart problems. Talk to your doctor about which drug is best for your
child.
BEHAVIOR THERAPY
Talk therapy for both the child and
family can help everyone understand and gain control of the stressful
feelings related to ADHD.
Parents should use a system of rewards
and consequences to help guide their child's behavior. It is important
to learn to handle disruptive behaviors. Support groups can help you
connect with others who have similar problems.
Other tips to help your child with ADHD include:

Communicate regularly with the child's teacher.

Keep
a consistent daily schedule, including regular times for homework,
meals, and outdoor activities. Make changes to the schedule in advance
and not at the last moment.

Limit distractions in the child's environment.

Make sure the child gets a healthy, varied diet, with plenty of fiber and basic nutrients.

Make sure the child gets enough sleep.

Praise and reward good behavior.

Provide clear and consistent rules for the child.

Alternative
treatments for ADHD have become popular, including herbs, supplements,
and chiropractic treatments. However, there is little or no solid
evidence that these work.

Expectations (prognosis)

ADHD is a long-term, chronic condition. If it is not treated appropriately, ADHD may lead to:

Drug and alcohol abuse

Failure in school

Problems keeping a job

Trouble with the law

About
half of children with ADHD will continue to have troublesome symptoms
of inattention or impulsivity as adults. However, adults are often more
capable of controlling behavior and masking difficulties.

Calling your health care provider

Call your doctor if you or your child's school personnel suspect ADHD. You should also tell your doctor about any:

Difficulties at home, school, and in relationships with peers

Medication side effects

Signs of depression

Prevention

Although
there is no proven way to prevent ADHD, early identification and
treatment can prevent many of the problems associated with ADHD.

References

Pliszka
S; AACAP Work Group on Quality Issues. Practice parameter for the
assessment and treatment of children and adolescents with
attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921.